Standing scrotal Ultrasound effective way for diagnosing Varicoceles, finds study

Nahid Punjani and team conducted a study, where they found out Standing  scrotal ultrasonography (SUS) detects more males with varicocele who would have gone undetected with supine scrotal ultrasonography alone.

The findings of this study was published in The Journal Of Urology on 1st October, 2021. The purpose of this study was to compare the clinical results of standing versus supine scrotal ultrasonography (SUS) for varicocele evaluation.

Researchers examined males diagnosed with varicocele between 2008 and 2020 who had documented SUS with both supine and standing evaluations, with and without Valsalva. Clinical results (semen parameters, TUNEL, and serum testosterone [T]) following microsurgical varicocelectomy were compared between men who had varicoceles identified by standing SUS (vein size >2.5 mm, vein size >3.0 mm, or reversal of flow) and those who would have been overlooked with supine SUS alone.

Varicocelectomy was performed on 349 males in total (right: 5 [1.4 % ]; left: 118 [33.8 % ]; bilateral: 226 [64.8 % ]). For vein size >2.5 mm, there was 56 men (16.1 %) on the right and 31 men (8.9 %) on the left, for vein size >3.0 mm, there was 64 men (18.3 %) on the right and 56 men (16.1 %) on the left, and for flow reversal, there was 36 (14.0 %) on the right and 40 (15.4 %) on the left. Only Testosterone showed substantial benefits on the left for individuals with a circumference greater than 2.5 mm. Significant differences were seen for sperm motility on the right, and TUNEL and T on the left, for those measuring more than 3.0 mm. Significant changes in sperm concentration, morphology, and volume on the right and TUNEL on the left were seen for flow reversal.

In conclusion, the efficiency of SUS is clearly demonstrated in assessment of varicoceles when compared to other traditional methods and clinicians and doctors are encouraged to opt for SUS in future testicular diagnosis and varicoceles. Furthermore, urologists should inform patients that the grade and side of the varicocele may have an impact on the predicted prognosis.

Reference:

Punjani, N., Wald, G., Al-Hussein Alawamlh, O., Dudley, V., & Goldstein, M. (2021). Standing Ultrasound Adds Clinical Utility for the Diagnosis of Varicoceles. Journal of Urology, 206(4), 1001–1008. https://doi.org/10.1097/ju.0000000000001877